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Food and medicine interaction

Asian ginseng (Panax ginseng) and warfarin (Coumadin, Jantoven)

ProbableEvidence level: probable. Case reports in people plus a known mechanism, but no controlled studies.

Last reviewed

What can happen

NCCIH says Asian ginseng may interfere with blood clotting. A case report described a drop in warfarin's effect after ginseng was started, but a randomized study in 25 stroke patients found no difference in INR with Panax ginseng.

Why it happens
Not established. Results in people have been inconsistent, with reports of both weaker and stronger warfarin effects.
At ordinary food amounts
Ginseng is mostly taken as a supplement or tea; regular use, and starting or stopping it, is what matters for INR.

What to do

If you take warfarin, talk to your prescriber before starting or stopping ginseng, and expect an extra INR check. Do not change your warfarin dose on your own.

Never stop or change a prescribed medicine without talking to the prescriber.

Common questions

Can I have asian ginseng (panax ginseng) while taking anticoagulants?

If you take warfarin, talk to your prescriber before starting or stopping ginseng, and expect an extra INR check. Do not change your warfarin dose on your own. Ginseng is mostly taken as a supplement or tea; regular use, and starting or stopping it, is what matters for INR.

Sources

  1. National Center for Complementary and Integrative Health. Asian Ginseng.
  2. Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm. 1997. PMID 9075501.
  3. Lee SH, et al. Interaction between warfarin and Panax ginseng in ischemic stroke patients. J Altern Complement Med. 2008. PMID 18637764.

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